Small-vessel vasculitis.
Small-vessel vasculitis.
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DOI：
10.1007/s11926-007-0049-3
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发表时间：
2007-08-01
影响因子：
5
通讯作者：
Matteson, Eric L
中科院分区：
文献类型：
--
作者：
Iglesias-Gamarra, Antonio;Restrepo, Jose Felix;Matteson, Eric L
小血管炎是一种以小静脉、毛细血管和/或小动脉的血管炎症为特征的多种疾病的简便描述，具有多形性的临床表现。典型的临床表型是伴有明显紫癜性白细胞性脉管炎，但不同器官的表现有很大不同。白细胞性血管炎的组织病理学检查显示血管中心性节段性炎症，纤维蛋白样坏死，血管壁周围有中性粒细胞渗出，伴有红细胞渗出。小血管炎的病因在许多病例中尚不清楚，但在另一些病例中，药物、病毒后综合征、恶性肿瘤、原发血管炎(如显微镜下的多动脉炎)和结缔组织疾病都与此有关。小血管炎的诊断有赖于全面的病史和体格检查，以及相关抗体检测，包括抗核抗体和抗中性粒细胞胞浆抗体、乙肝和丙型肝炎血清、补体、免疫球蛋白、血细胞计数、血清肌酐、肝功能检查、尿液分析、放射成像和活检。
Small-vessel vasculitis is a convenient descriptor for a wide range of diseases characterized by vascular inflammation of the venules, capillaries, and/or arterioles with pleomorphic clinical manifestations. The classical clinical phenotype is leukocytoclastic vasculitis with palpable purpura, but manifestations vary widely depending upon the organs involved. Histopathologic examination in leukocytoclastic vasculitis reveals angiocentric segmental inflammation, fibrinoid necrosis, and a neutrophilic infiltrate around the blood vessel walls with erythrocyte extravasation. The etiology of small-vessel vasculitis is unknown in many cases, but in others, drugs, post viral syndromes, malignancy, primary vasculitis such as microscopic polyarteritis, and connective tissue disorders are associated. The diagnosis of small-vessel vasculitis relies on a thorough history and physical examination, as well as relevant antibody testing including antinuclear antibody and antineutrophil cytoplasmic antibody, hepatitis B and C serologies, assessment of complement, immunoglobulins, blood count, serum creatinine, liver function tests, urinalysis, radiographic imaging, and biopsy.